A cross-sectional survey of attitudes and barriers toward pharmacist services at predoctoral academic dental institutions.

BACKGROUND: The pharmacy profession continues to evolve through novel practice settings and collaborations. Recent reports have highlighted services provided by pharmacists in academic dental settings. OBJECTIVES: This study aimed to measure attitudes and barriers to pharmacist services at academic dental institutions via a survey of dental school administrators. METHODS: A survey was circulated in summer 2019 to all accredited dental schools in the United States through the American Dental Education Association clinic dean listserv. The survey consisted of Likert scale questions pertaining to barriers and attitudes regarding pharmacist services in dental education programs and clinics. The survey was open from July 2019 to December 2019. Responses were analyzed with descriptive statistics and Spearman rank correlation. RESULTS: Complete attitude and barrier responses were received from 30 of 66 accredited institutions. Responding schools showed a generally positive attitude toward pharmacist services. Respondents identified funding as the barrier with greatest impact on program development and expansion. CONCLUSION: Attitudes among dental education program administrators regarding pharmacists are generally positive. Barriers remain to fully incorporating pharmacists into dental institutions in the United States. Increased funding and reimbursement for pharmacy services would support universal pharmacist integration to this practice setting.

ROLE OF LIBRARIANS AND INFORMATION PROFESSIONALS IN IDENTIFYING dPROS IN THE EVIDENCE.

While dental patient-reported outcomes provide important insight to why patients seek oral health care, finding research literature on these outcomes as well as measures for dental patient-reported outcomes is quite difficult due to a lack of standardization in both indexing terms as well as reporting practices. This results in these outcomes and measures often being underutilized. Librarians and information professionals are experts in navigating and managing research literature. Additionally, librarians are powerful collaborators for evidence-based practice, and can provide support for research methodology design and reporting. This article explores how partnering with librarians and information professionals can benefit clinicians and researchers to further the utilization of dental patient-reported outcomes in patient care.

Assessing the roles and challenges of librarians in dental systematic and scoping reviews.

OBJECTIVE: The objective of this study was to determine the scope of experience, roles, and challenges that librarians face in participating in dental and oral health systematic and scoping reviews to inform outreach efforts to researchers and identify areas for librarian professional development. METHODS: The authors developed a twenty-three-item survey based on the findings of two recent articles about health sciences librarians' roles and challenges in conducting systematic and scoping reviews. The survey was distributed via electronic mailing lists to librarians who were likely to have participated in conducting dental systematic and scoping reviews. RESULTS: While survey respondents reported participating in many dental reviews, they participated more commonly in systematic reviews than in scoping reviews. Also, they worked less commonly on dental and oral health reviews than on non-dental reviews. Librarian roles in dental reviews tended to follow traditional librarian roles: all respondents had participated in planning and information retrieval stages, whereas fewer respondents had participated in screening and assessing articles. The most frequently reported challenges involved the lead reviewer or review team rather than the librarians themselves, with time- and methodology-related challenges being most common. CONCLUSIONS: Although librarians might not be highly involved in dental and oral health systematic and scoping reviews, more librarian participation in these reviews, either as methodologists or information experts, may improve their reviews' overall quality.

Associations between dental caries and systemic diseases: a scoping review.

BACKGROUND: The objective of this study was to evaluate and present evidence from animal and human clinical studies on associations between dental caries and systemic diseases, and to suggest potential mechanisms that might explain such associations. METHODS: An electronic search was conducted of PubMed, Embase and Cochrane Central Register of Controlled Trials for articles published from 2010 to 2020 in the English language. From the initial search, 404 full-text studies were assessed for eligibility. After excluding studies for technical and study limitations, a total of 67 studies were included in the summary tables and additional studies were included in the review to support evidence. RESULTS: Few systemic disease and conditions were found to be clinically meaningfully associated with caries experience. Best evidence from human and animal studies described association between metabolic diseases and dental caries. Several interesting animal studies were noted that could generate clinical hypotheses and further investigations in rodent models for cardiovascular injury and hyperglycemia. Inadequate data was found to suggest any modifications to current clinical practice or prevention guidelines. CONCLUSIONS: Limited clinical evidence was found connecting several systemic diseases and dental caries. Inadequate data was found to suggest any modifications to current clinical practice or prevention guidelines. CLINICAL SIGNIFICANCE: Understanding of associations between dental caries and systemic diseases play a crucial role in the treatment planning and education of the dental patient.

Role of periodontal therapy in management of common complex systemic diseases and conditions: An update.

The goal of this review is to summarize the results of randomized trials reported since 2010 that assessed the effect of periodontal interventions on at least one systemic outcome in human subjects of any age, gender or ethnicity. Oral outcome measures included gingivitis, pocket depth, clinical attachment loss and/or radiographic bone loss and oral hygiene indices. Studies were excluded if the trial was not completed or if treatment was not randomized. The results suggest that nonsurgical periodontal intervention provided to pregnant women is safe and improves periodontal status without preventing adverse pregnancy outcomes. Nonsurgical periodontal intervention was also found to provide modest improvement in glycemic control in individuals with type 2 diabetes mellitus and periodontitis. Also, improving oral care through mechanical or chemical control of dental-plaque biofilm formation can contribute to the prevention of respiratory infections in differing clinical settings, including hospitals and nursing homes, and in patients with chronic obstructive pulmonary disease. No clinical trials were reported that tested the effect of periodontal interventions on medical outcomes of atherosclerosis, cardiovascular diseases, stroke, rheumatoid arthritis, Alzheimer's disease, chronic kidney disease or malignant neoplasia.

American Association of Orthodontists Foundation Craniofacial Growth Legacy Collection in the orthodontic literature-use and trends: A systematic review.

INTRODUCTION: The American Association of Orthodontists Foundation (AAOF) Craniofacial Growth Legacy Collection is a digital repository of records from 9 craniofacial growth study collections in the United States and Canada. The purposes of this article were to describe the use of materials from the AAOF Craniofacial Growth Legacy Collection in the orthodontic literature in comparative and follow-up studies, and to analyze trends before and after the project's launch in 2009. METHODS: An electronic search without date or language restriction was conducted in the following databases: PubMed, Embase, Evidence-Based Medicine Reviews, and CINAHL. Grey literature resources and the bibliographies of the selected studies were also consulted. Three independent reviewers assessed the studies for inclusion. The criteria were human subjects of any age, sex, and ethnicity; at least 1 of the 9 AAOF legacy collections used as either the main sample population or the comparison or control; and orthodontic outcomes assessed. Data were analyzed using STATA software (version 14.2; StataCorp, College Station, Tex). RESULTS: A total of 199 studies (127 follow-up, 72 comparative) were included. The most commonly used collection in comparative studies was the Michigan Growth sample. The number of published studies more than doubled after the AAOF Legacy Collection project testing and launch in 2009. The increase continued through 2010 to 2014, during which there was a trend to use multiple collections. The Burlington Growth collection was the most commonly used collection for follow-up studies. The overall use of the legacy collection showed a small increase in published studies after 2009. CONCLUSIONS: The overall numbers of published studies in the comparative and follow-up categories increased after 2009, reflecting the efforts of the AAOF team and collection curators to make the records available worldwide. Further research should consider studying each collection to identify utilization predictors.

The influence of proton pump inhibitors on tissue attachment around teeth and dental implants: A scoping review.

OBJECTIVES: Proton pump inhibitors, such as omeprazole and pantoprazole, are frequently prescribed for the treatment of acid reflux. However, those medications have been shown to affect a variety of physiologic processes, including bone homeostasis and the gastrointestinal microbiome. The objective of this study was to assess the relationship between proton pump inhibitors and attachment levels around teeth and dental implants. A scoping review was performed to assess the extent and quality of the relevant literature. MATERIALS AND METHODS: We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) and searched four relevant biomedical literature databases in addition to the grey literature. Keywords in the title and abstract fields, and subject headings for proton pump inhibitors, teeth, and dental implants were included as search terms. RESULTS: Overall search results identified 791 publications which, after applying the inclusion and exclusion criteria, yielded 27 publications that were further analyzed for relevance and quality of scientific evidence. The majority of eligible publications were retrospective cohort studies. Following critical analysis, 13 publications, including six abstracts, were used to assess the effect of proton pump inhibitors on tissue attachment around teeth and dental implants. CONCLUSIONS: There are few high-quality studies describing the effect of proton pump inhibitors on tissue attachment around teeth and dental implants. Nevertheless, among the included papers with the fewest confounding factors, there was a positive relationship between proton pump inhibitors and soft tissue attachment levels around teeth, and a predominantly negative but variable effect of proton pump inhibitors on the bone level around dental implants. Additional well-controlled prospective studies are required to fully elucidate those relationships.

An environmental scan of pharmacists supporting pre-doctoral dental education institutions.

PURPOSE/OBJECTIVES: Reports have described pharmacists providing services within academic dental settings. The full scope of these activities and where they exist is unreported. This environmental scan was performed to identify and summarize the levels in which pharmacists provide support to predoctoral dental education programs. METHODS: A survey was circulated in summer 2019 to all CODA accredited dental schools through the American Dental Education Association (ADEA) clinical dean listserv. The IRB approved survey consisted of 23 questions pertaining to the pharmacist's role in predoctoral dental education programs. Institutions were asked whether pharmacists were used and what kinds of services pharmacists provided. Pharmacist roles were classified into standard pharmacy services, clinical pharmacy services, medication inventory, education, and administration/research. Univariate analysis was performed on responses and reported using descriptive statistics. RESULTS: A response rate of 59.1% from 66 institutions was achieved. Of those responding, 28.21% reported utilizing a pharmacist at their institution. Of the institutions responding positively to utilizing a pharmacist, the most common standard pharmacy services used were patient counseling regarding a disease state (50%), and medication errors/adverse event reporting (60%). Some clinical pharmacy services provided were medication history collection (70%), advising antimicrobial selection (50%), and treatment plan consultation (60%). Pharmacists were also found to be active in education, school administration, and research. CONCLUSION: Pharmacists are utilized at just over a quarter of responding CODA accredited predoctoral dental education institutions in the United States. Where deployed, pharmacists provide a wide array of services.

Types and roles of reviews of the literature in dental education.

Systematic reviews have consistently grown in popularity and reputation. On behalf of the Dental Caucus of the Medical Library Association and with insight from the Director of Faculty Education & Instructional Development at Tufts University School of Dental Medicine, we offer guidance on the wide variety of reviews of the literature available to aid researchers in dental education in selecting the best review to suit their question, team size, time, and needs of the profession.

Relationship between hypothyroidism and periodontitis: A scoping review.

AIM: The objective of this study was to assess the existing literature to determine if a relationship exists between hypothyroidism and periodontitis. METHODS: We used a modified approach to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses by searching five databases in addition to the gray literature. Keywords in the title and abstract fields, as well as subject headings for both periodontal disease and hypothyroidism, were used to search the existing literature for publications relevant to evaluation of the thyroid-periodontitis relationship. RESULTS: The authors screened 847 unique publications which, after applying inclusion and exclusion criteria, yielded 29 publications, which were further analyzed for relevance and applicability. Most of the included papers were cross-sectional studies and retrospective chart reviews. Following critical analysis, four publications, including one abstract, were used to further assess the hypothyroid-periodontitis relationship. CONCLUSIONS: There are very few high-quality studies describing the potential association between hypothyroidism and periodontitis. In general, and among the included papers with the fewest confounding factors, a positive relationship between hypothyroidism and periodontitis was found. Further well-controlled, prospective clinical and immunologic studies will be required to confirm that relationship.

A Systematic Review of Critical Thinking Instruments for Use in Dental Education.

Critical thinking is widely recognized as an essential competency in dental education, but there is little agreement on how it should be assessed. The aim of this systematic review was to determine the availability of instruments that could be used to measure critical thinking in dental students and to evaluate psychometric evidence to support their use. In January 2017, an electronic search of both the medical and education literature was performed on nine databases. The search included both keyword and Medical Subject Heading terms for critical thinking, higher education/health sciences education, measurement/assessment, and reproducibility of results. The grey literature was included in the search. The search produced 2,977 unique records. From the title and abstract review, 183 articles were selected for further review, which resulted in 36 articles for data extraction. Ten of these studies sought to evaluate psychometric properties of the instruments used and were subjected to quality assessment. Seven assessment instruments were identified. Of these, three instruments that have not been widely used nor tested in health professions students showed evidence of psychometric strength and appeared to have potential for use in dental education. Further research should focus on the three critical thinking instruments with strong psychometric evidence, with the aim of establishing validity and reliability in the context of dental education.